Basic Information
| Provider Information | |||||||||
| NPI: | 1225285331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHELLE H KLINGER LMW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30445 W 14 MILE RD APT 70 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483341549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482100523 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31700 W 13 MILE RD | ||||||||
| Address2: | SUITE 219 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483342166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482100523 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2008 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | KLINGER | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHOTHERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 2482100523 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LMSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | 6801078103 | MI | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.